The relative locations of the supraorbital, infraorbital, and mental foramina: A cadaveric study.

The purpose of this study is to investigate the applicability of the current surgical guideline stating that the main facial foramina that transmit cutaneous nerves to the face (supraorbital notch/foramen, infraorbital foramen, and mental foramen) are equidistant from the midline in European and Hispanic populations. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data have been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 67 cadavers donated to the Human Anatomy Program at UT Health San Antonio. The supraorbital, infraorbital, and mental foramina were dissected and midline structures including the crista galli, internasal suture, anterior nasal spine, and mandibular symphysis were identified. The distance from each foramen to midline was recorded using a digital caliper. For all cadavers/ethnicities studied, the supraorbital, infraorbital, and mental foramina were 25.32 mm, 29.57 mm, and 25.55 mm to the midline, respectively. Thus, the infraorbital foramen is located significantly more lateral compared to the supraorbital (p < 0.0001) and mental foramina (p < 0.0001). After dividing the sample based on ethnicity, this relationship was also true for the European sample and tended to be true for the Hispanic sample. Significant anatomical variations exist in the current surgical guideline stating that the supraorbital foramen, infraorbital foramen, and mental foramen are equidistant from the midline. Clinicians may need to adjust their methodology during surgical procedures of the face in order to optimize patient care.

A cadaveric study investigating the anatomy of the medial orbital wall.

The purpose of this study is to investigate the applicability of the current surgical guideline, known as '24-12-6' surgical guideline, in the Hispanic and European populations. This guideline is used during numerous orbital surgeries and states that the distance between the anterior lacrimal crest (ALC) to the anterior ethmoidal foramen (AEF) (24 mm), the AEF to the posterior ethmoidal foramen (PEF) (12 mm), and the PEF to the optic canal (OC) (6 mm) follows a Rule of Halves. Previous studies suggest this surgical guideline is not applicable for all ethnicities; however, to our knowledge, no data has been published regarding the accuracy of this guideline pertaining to the Hispanic population. An experimental study was performed on 79 orbits (52 cadavers) donated to the Human Anatomy Program at UT Health San Antonio. The ALC, AEF, posterior ethmoidal foramen, and OC were identified; the orbit was enucleated and all remaining soft tissue removed. The distance between each landmark was recorded using a digital caliper. For all cadavers studied, the distances between the ALC, AEF, posterior ethmoidal foramen, and OC were 24.76 mm, 13.89 mm, and 7.61 mm, respectively. Thus, the '24-12-6' surgical guideline was not applicable to the sample studied. Based on ethnicity data, these relationships were also not true for the European or the Hispanic populations. Therefore, significant anatomical variations exist in the current surgical guideline. Clinicians may need to adjust their methodology during surgical procedures in order to optimize patient care.